MEDICARE: ADINA SHAPIRO, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	0904004355	VA

General Provider Information

NPI Number	:	1194999581
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADINA SHAPIRO, LCSW

Provider Business Mailing Address
First Line	:	1495 CHAIN BRIDGE RD STE 202
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22101-5727
Country	:	US
Telephone Number	:	703-761-3939
Fax Number	:	571-633-9798

Provider Business Practice Location Address
First Line	:	1495 CHAIN BRIDGE RD STE 202
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22101-5727
Country	:	US
Telephone Number	:	703-761-3939
Fax Number	:	571-633-9798

Authorized Official
Title or Position	:	LCSW
Name	:	ADINA Y SHAPIRO
Credential	:
Telephone Number	:	703-761-3939

Provider Enumeration Date	:	04/16/2008
Last Update Date	:	05/05/2008

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